Characteristics and Prognosis of Microscopic Polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

作     者：Yu Gu Ting Zhang Min Peng Juhong Shi Yu Gu;Ting Zhang;Min Peng;Juhong Shi

作者机构：Department of Respiratory and Critical Care MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China 

出 版 物：《Chinese Medical Sciences Journal》 (中国医学科学杂志（英文版）)

年 卷 期：2022年第37卷第4期

页      面：293-302页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：microscopic polyangiitis diffuse alveolar hemorrhage interstitial lung disease mortality risk factors 

摘      要：Objective To evaluate the clinical characteristics and prognostic predictors of patients with diffuse alveolar hemorrhage(DAH)and/or interstitial lung disease(ILD)secondary to microscopic polyangiitis(MPA)in a Chinese general *** We retrospectively reviewed the medical records of MPA patients admitted to internal medicine departments between the year 2002 and *** patients were divided into the ILD,DAH,DAH combined with ILD(DAHILD),and no pulmonary involvement(NPI)groups according to pulmonary involvement *** clinical characteristics at diagnosis were *** risk factors associated with short-term death and long-term death were identified with Logistic regression and Cox *** Of 193 newly diagnosed MPA patients,181 patients were enrolled in the research,of which 19 had DAH alone,96 had ILD alone,18 had DAH and DAH concurrently,and 48 had *** median of serum creatine level in the DAH group was 449μmol/L,significantly higher than that in the ILD group(123μmol/L,Nemenyi=-35.215,P=0.045)and DAHILD group(359μmol/L,Nemenyi=-43.609,P=0.007).The median follow-up time was 67(range:1-199)*** in the ILD group were older than those in the DAH group(median:69 years vs.57 years,Nemenyi=43.853,P=0.005).The patients with both DAH and ILD had combined features of the two subtypes,and the highest mortality(72.2%at the end of follow-up).The elevated white blood cell count was a risk factor for short-term death(OR=1.103,95%CI:1.008-1.207,P=0.032 for one month;OR=1.103,95%CI:1.026-1.186,P=0.008 for one year).Old age(HR=1.044,95%CI:1.023-1.066,P0.001),cardiovascular system involvement(HR=2.093,95%CI:1.195-3.665,P=0.010),poor renal function(HR=1.001,95%CI:1.000-1.002,P=0.032)were risk factors for long-term *** infections(38/54)were the leading causes of death,especially for the patients with ***,49 patients suffered from pulmonary infections in the first year after *** MPA patients who prese